Organization | Year | Population | Endorse LDCT | Recommended Setting | Smoking Cessation | SDMa |
---|---|---|---|---|---|---|
National Comprehensive Cancer Network (NCCN)9 | 2012 | NLST criteria,8 aged ≥50 years with ≥20 pack-years plus 1 risk factorb and 1.3% PLCO risk | Yes | Multidisciplinary team | Yes | Yes |
American Association for Thoracic Surgery10 | 2012 | Aged 55-79 or 50-79 years based on smoking history and other factorsc | Yes | Multidisciplinary team | Yes | |
US Preventive Services Task Force11 | 2013 | Age pack-year and current smoker or quit ≤ 15 years | Yes | Primary care; NCCN guidance | Yes | Yes |
American Cancer Society12 | 2013 | NLST + imaging/treatment feasible | Yes | NLST-like | Yes | |
American College of Chest Physicians13 | 2013 | NLST | Yes | NLST-like | Yes | |
American Lung Association14 | 2015 | NLST | Yes | NLST-like | Yes | Yes |
Canadian Task Force on Preventive Health Care15 | 2016 | NLST | Yes | Early diagnosis/treatment expertise | Yes | |
European Union16 | 2017 | Validated risk stratification | Yes | Multidisciplinary teams | Yes | |
CHEST Guideline17 | 2018 | 55-77 years/NLST smoking criteria | Yes | Yes | ||
AAFP18 | 2013 | High risk (age and smoking) | Noa | Yes | Yes | |
CMS19 | 2015 | 55-77 years/NLST smoking criteria | Yes | Provider/facility quality | Yes | Yes |
AAFP = American Academy of Family Physicians; CHEST = American College of Chest Physicians; CMS = Centers for Medicare and Medicaid Services; LDCT = low-dose helical CT; NLST = National Lung Screening Trial; PLCO = Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial; SDM = shared decision making.
↵a Shared decision making endoresed or implied.
↵b Other NCCN risk factors include radon exposure, occupational exposure, history of cancer, family history of lung cancer, COPD, and pulmonary fibrosis.
↵c People aged 55-79 years with ≥30 pack-year of smoking history or people aged 50-79 years with ≥20 pack-year of smoking history with personal lung cancer history or another risk factor such as COPD, environmental or occupational exposure, prior cancer or radiation therapy, genetic predisposition or family history.
d Insufficient evidence to recommend screening. Screening cannot be recommended on the basis of a single study conducted in major medical centers.